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Novel Computerised Ultrasound Tomography in Echo Mode - CUTE: Multimodal Ultrasound Imaging for Accurate Diagnosis and Treatment Control

Applicant Jaeger Michael
Number 142585
Funding scheme Ambizione
Research institution Institut für angewandte Physik Universität Bern
Institution of higher education University of Berne - BE
Main discipline Biomedical Engineering
Start/End 01.09.2012 - 31.08.2015
Approved amount 593'352.00
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All Disciplines (8)

Discipline
Biomedical Engineering
Infectious Diseases
Surgery
Cancer
Clinical Cancer Research
Mathematics
Internal Medicine
Technical Physics

Keywords (7)

sound speed; cancer; adaptive imaging; ultrasonic imaging; treatment monitoring; novel diagnostics; liver disease

Lay Summary (English)

Lead
Lay summary

Today’s clinical practise goes in direction of early disease detection with the goal of prevention instead of expensive treatment, to minimise patient distress and reduce health care cost. Medical imaging is at the pulse of this development, and it is growingly perceived that multimodal imaging combining the merits of different techniques is the key to more accurate diagnosis and patient-tailored therapy.

Among the various modalities, ultrasound is low-cost and non-ionising, and real-time and free-hand operation makes it easy to quickly access different parts of the body. Therefore ultrasound is well established in human medicine. In spite of its great potential, however, the greyscale image provided by ultrasound does often not allow accurate distinction of different disease types which then make subsequent use of CT/MRI mandatory.

My vision is therefore the advancement of ultrasound far beyond the state-of-the-art, augmenting conventional ultrasound with novel ultrasound-based contrast modes to a multi-modal imaging facility in its own right. This will unify the virtues of real-time operability and patient safety with the diagnostic accuracy of combined imaging. Within this project, I will address a key point to this development, the knowledge of the local sound speed inside the tissue. To date, sound speed is assumed constant when imaging the human body using ultrasound, although in reality sound speed varies on the order of few percents between different tissue types. As a consequence, current ultrasound imaging is inaccurate and often renders deep imaging difficult.

Within this Ambizione project, I will therefore develop a novel method that allows imaging the sound speed with high contrast and high resolution for integration with conventional clinical ultrasound: Computerised Ultrasound Tomography in Echo Mode - CUTE. This will resolve two current shortcomings of ultrasound in two ways at the same time: Knowing the sound speed will allow more accurate image reconstruction and will directly benefit diagnostics and ultrasound-assisted interventions. In addition, sound speed provides a novel diagnostic modality in its own right! Because disease influences sound speed, an image of the local sound speed will allow more accurate diagnosis of disease type and margins than it is possible today, and replace X-ray, MRI, and CT in many situations.

Within the Ambizione project, the advantages of CUTE will be demonstrated based on a research ultrasound scanner, and the method will be further investigated and developed to clinical applicability. First clinical pilot studies will confirm contrast and resolution in cancer and liver diseases, and, in addition to that, the potential of CUTE for temperature monitoring in high intensity focused ultrasound treatment of cancer will be investigated. Upon completion, further integration of CUTE with US-based modalities such as photoacoustic imaging and shear wave elastography will result in high diagnostic accuracy multimodal ultrasound imaging. In summary this project will benefit clinical practise and potentially the welfare of millions of patients. 

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Full correction for spatially distributed speed-of-sound in echo ultrasound based on measuring aberration delays via transmit beam steering
Jaeger Michael (2015), Full correction for spatially distributed speed-of-sound in echo ultrasound based on measuring aberration delays via transmit beam steering, in Physics in Medicine and Biology, 60, 4497.
Towards clinical computed ultrasound tomography in echo -mode: Dynamic range artefact reduction
Jaeger Michael (2015), Towards clinical computed ultrasound tomography in echo -mode: Dynamic range artefact reduction, in Ultrasonics, 62, 299.
Computed ultrasound tomography in echo mode (CUTE) of speed of sound for diagnosis and for aberration correction in pulse-echo sonography
Jaeger Michael (2014), Computed ultrasound tomography in echo mode (CUTE) of speed of sound for diagnosis and for aberration correction in pulse-echo sonography, in Medical Imaging 2014: Ultrasonic Imaging and Tomography, 9040, 90400A.
Computed ultrasound tomography in echo mode for imaging speed of sound using pulse-echo sonography: Proof of principle
Jaeger Michael (2014), Computed ultrasound tomography in echo mode for imaging speed of sound using pulse-echo sonography: Proof of principle, in Ultrasound in Medicine & Biology, 0.
Effect of irradiation distance on image contrast in epi-optoacoustic imaging of human volunteers
Held Gerrit (2014), Effect of irradiation distance on image contrast in epi-optoacoustic imaging of human volunteers, in Biomedical Optics Express, 5(11), 3765-3780.
Increase of penetration depth in real-time clinical epi-optoacoustic imaging: clutter reduction and aberration correction
Jaeger Michael (2014), Increase of penetration depth in real-time clinical epi-optoacoustic imaging: clutter reduction and aberration correction, in Photons Plus Ultrasound: Imaging and Sensing 2014, 8943, 89430Q.
Influence of illumination position on image contrast in epi-optoacoustic imaging of human volunteers
Preisser Stefan (2014), Influence of illumination position on image contrast in epi-optoacoustic imaging of human volunteers, in Photons Plus Ultrasound: Imaging and Sensing 2014, 8943, 894346.
Real-time clinical clutter reduction in combined epi-optoacoustic and ultrasound imaging
Jaeger Michael (2014), Real-time clinical clutter reduction in combined epi-optoacoustic and ultrasound imaging, in Photonics & Lasers in Medicine, 0(0), 0.
Real-time clutter reduction in epi-optoacoustic imaging of human volunteers
Jaeger Michael (2014), Real-time clutter reduction in epi-optoacoustic imaging of human volunteers, in Medical Imaging 2014: Ultrasonic Imaging and Tomography, 9040, 90400N.
Clutter elimination for deep clinical optoacoustic imaging using localised vibration tagging (LOVIT)
Jaeger Michael (2013), Clutter elimination for deep clinical optoacoustic imaging using localised vibration tagging (LOVIT), in Photoacoustics, 1, 19-29.

Collaboration

Group / person Country
Types of collaboration
Department of Diagnostic Radiology, Bern University Hospital Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Universitätsklinik für Viszerale Chirurgie und Medizin (UVCM), University Hospital Bern Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Institute of Cancer Research, Sutton, Surrey Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Associated projects

Number Title Start Funding scheme
127274 Deep optoacoustic imaging with nanoparticle enhanced contrast 01.10.2009 Project funding (Div. I-III)

Abstract

Today’s clinical practise goes clearly in direction of early disease detection and personalised medicine, with the goal of prevention instead of expensive treatment, to minimise patient distress and reduce health care cost. Medical imaging is at the pulse of this development, and it is growingly perceived that multimodal imaging combining the merits of different techniques (ultrasound, CT, MRI, PET, etc.) is the key to more accurate diagnosis and patient-tailored therapy. Among the various imaging modalities, ultrasound (US) is comparably low-cost, non-ionising, and provides the patient short, comfortable sessions. Real-time and free-hand operation makes it easy to quickly access different parts of the body, and is well established in human medicine: US is routinely used for diagnosing pathological conditions such as cancer of breast, liver, kidney, pancreas, and for liver fibrosis, cirrhosis, fungal infections etc. Apart from that it regularly finds application as a metric tool for e.g. arterial wall thickness, pre-natal morphology, tumour diameter etc, and in interventions where real-time operability is vital such as US-guided needle biopsy, computer-assisted surgery, and in US-guided radiotherapy of cancer. In spite of its great potential, US has often limited benefit: It provides mainly a single contrast mode (brightness or B-mode), together with little functional imaging (Doppler flow of the vascular system). With the wide range of diseases that show up on B-mode, difficulties in differential diagnosis often make subsequent use of CT/MRI mandatory. Acoustic aberrations play an important role, which on one hand degrade contrast and resolution of deep tissue structures, and on the other hand distort the image, affecting accuracy of geometric measures as well as of US-assisted interventions. My vision is the advancement of US far beyond the state-of-the-art, to a save, low cost, and portable imaging tool for both accurate and rapid diagnostics and treatment control. The technical development of the last decade already provides us with strongly miniaturised, laptop sized US systems that can be versatilely employed at the point-of-care and emergency level. For significant clinical benefit, this development has to go hand-in-hand with improved diagnostic accuracy: Augmenting conventional US with novel ultrasound-based contrast modes to a multi-modal US imaging facility in its own right will unify the virtues of real-time operability and patient safety with the diagnostic accuracy of combined imaging. The key to such a development is accurate knowledge of the local sound speed when imaging the tissue. Knowing the sound speed spatially resolved will allow accurate acoustic aberration correction and thus a quantum leap in image resolution and contrast, as well as metric accuracy, compared to state-of-the art technology. This will directly benefit accuracy of diagnostics and US-assisted interventions. On the other hand, local sound speed provides an additional contrast modality in its own right! Sound speed has been shown to be a disease marker for cancer and liver disease and potentially for many other disease types. Spatially resolved sound speed will therefore allow more accurate diagnosis of disease type and margins using ultrasound than it is possible today, and replace X-ray, MRI, and CT in many situations. In addition to that, local sound speed will provide a measure of the local body temperature for real-time feedback of dose delivery in high-intensity focused ultrasound surgery (HIFU)! Previous development towards sound speed imaging in the field of ultrasound computed tomography (UCT) can only be applied to the breast and requires expensive standalone systems. For broad and low cost clinical application, sound speed imaging must be integrated with conventional real-time, freehand, reflection mode ultrasound! This is exactly where I will make an impact: Within the Ambizione project I will develop real-time sound speed imaging with high contrast (1% sound speed) and high resolution (1 mm) for integration with conventional clinical ultrasound scanners: Computerised Ultrasound Tomography in Echo Mode - CUTE. As additional contrast mode in combination with routine US scans, CUTE will for the above mentioned reasons be a quantum leap in diagnostic ultrasound imaging. Preliminary theoretical work strongly supports the feasibility of my novel method. Within the Ambizione project, the experimental implementation of CUTE on a research ultrasound scanner will allow the basic research to prove the applicability and advantages of this new technique, and the further investigation and development of the method to clinical applicability. My project goal is first clinical pilot studies where I will confirm contrast and resolution of CUTE in cancer and liver imaging, and improved resolution of deep B-mode based on CUTE aberration correction. In addition to that, I will investigate the potential for temperature monitoring in HIFU. Within Ambizione I will go significantly beyond the state-of-the-art of existing ultrasound data acquisition sequencing, data processing, and image reconstruction. Upon completion, I will investigate the further integration of CUTE with US-based modalities such as photoacoustic imaging and shear wave elastography, for highly sophisticated, high diagnostic accuracy, multimodal US imaging. Therefore the Ambizione project will entail huge potential for further development and projects. In summary this will induce an avalanche of new applications and projects in the field of physics in medicine and in clinical practise, benefiting the welfare of millions of patients.
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